Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 13438 | MD |
NPI | 1013099357 |
---|---|
Provider Name | Dr. Bindu Reddy |
First Address | Clinton, MD 20735 |
Second Address | Clinton, MD 20735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |